Childhood optic neuritis: the pediatric neurologist's perspective

Eur J Paediatr Neurol. 2009 Sep;13(5):452-7. doi: 10.1016/j.ejpn.2008.09.003. Epub 2008 Oct 21.

Abstract

Background: Optic neuritis in children may be an isolated, usually postinfectious event, or the symptom of a more widespread disorder.

Aim: To investigate the etiological spectrum of optic neuritis in children in association with diagnostic findings and follow-up results.

Methods: We retrospectively examined the records of 31 children aged 4-15 (mean 9.7+/-2.9) years in whom isolated optic neuritis was the presenting neurological symptom.

Results: Monophasic bilateral optic neuritis was the most common presentation (45%), followed by the unilateral (32%) and recurrent (22%) forms. Initial cranial MRI was abnormal in 12/31 patients. During a mean follow-up of 2.2 years (6 months-15 years), 6/14 bilateral cases, 9/10 unilateral and 5/7 recurrent cases were diagnosed with various disorders including total eight with MS. The MS group tended to start with unilateral optic neuritis, was older (mean 11.6+/-1.5 vs. 8.8+/-2.9 years), and included more girls than the other groups.

Conclusions: Optic neuritis in children is frequently part of a systemic or neurological disorder even in the presence of normal cranial imaging. These patients should be evaluated and followed-up in pediatric neurology clinics.

MeSH terms

  • Adolescent
  • Age Factors
  • Chickenpox / complications
  • Child
  • Child, Preschool
  • Female
  • Follow-Up Studies
  • Functional Laterality / physiology
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Methylprednisolone / therapeutic use
  • Mumps / complications
  • Neuromyelitis Optica / etiology
  • Optic Neuritis / epidemiology
  • Optic Neuritis / etiology
  • Optic Neuritis / therapy*
  • Recovery of Function
  • Recurrence
  • Rubella / complications
  • Sex Factors

Substances

  • Methylprednisolone